ComplaintsforCambia
Health Insurance
Multi Location Business
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Complaint Details
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Initial Complaint
09/13/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
They called claiming to be my insurance got my date of birth and asked for my **** name but didn'y know where I was located. It felt scamyInitial Complaint
09/04/2024
- Complaint Type:
- Billing Issues
- Status:
- Unanswered
I've made at least four phone calls and wasted hours of my life trying to get Regence Bluecross/Blueshield of Oregon to refile a insurance claim from 3/7/24 for $2,440.11. My wife had a in network procedure done and they didn't apply the correct about of insurance paid to our bill. I initially talked to a customer service *** who said the claim was coded incorrectly on their part and they would ***rocess it. That phone call was back in May. I'm now getting letters from the provider (providence) who says I owe them money and they are going to turn it over to debt collectors if we don't pay. I will not pay this bill until Regence has processed it correctly. I've called Regence multiple times after and they just say "oh yeah it's in our system to ***rocess this we will get to it." But nothing happens. These health insurance companies cost a fortune per month for healthcare premiums yet can't seem to do their job right.Initial Complaint
07/22/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
Child is not getting the proper care that is needed from the insurance company. He needs the hearing aid to hear but, the insurance company is saying that he is not medically cleared to get it when he's been deaf for all his life. He had a hearing aid ever since he was younger and the insurance company is still denying the claim even though everything is submitted.Initial Complaint
01/23/2024
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
Regence Blue Shield sends out frequent emails regarding their ability to cover mental health related problems, saying to "Make the most of your 2023 Regence BlueShield of Idaho benefits". After seeing this and my basic EOB page only showing a $40 copay with the Medical Benefit Booklet page being not functional, I decided to start therapy. However, weeks later, Regence tells me now that they do not actually cover this service that they have been pushing and advertising the entire time and I now have to pay for these services primarily out of pocket. Given their broken website, I had no way of knowing this until I had already spent hundreds of dollars on therapy treatments.Initial Complaint
09/14/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
Cambia has not responded to a claim o made months and months ago. No response to numerous emails. Avoid them at all costsCustomer response
10/15/2023
Hi Bbb - for some reason this complaint is marked as a duplicate. This is a new complaint on a new claim. I'd be happy to get you further information. Thanks for your time and have a nice day. ****
Customer response
10/17/2023
Just wanted to check in on this complaint It is a new compalint on a new claim denial. Thanks!Initial Complaint
09/05/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Unanswered
Regence Health Insurance has neglected to reimburse thousands of dollars of medical claims, dating back to before the pandemic. Their denials are unjustified - requesting information that is very clearly listed on invoices, denying coverage of claims that are covered (and in some cases, have been covered previously) - and they have been unresponsive to emails and calls. I have provided supporting documents, including emails, chat transcripts, and messages exchanged with the insurance company. Regence has more extensive records but this should be a start - they said they could and will share a line list of all reimbursement claims, the date the request was made, the amount, the status of the request, and any reason for denial of claim.Despite my efforts to resolve this matter directly with Regence, the issue remains unresolved, and I am seeking assistance from the Better Business Bureau to secure the reimbursement I am owed, along with any applicable interest.Initial Complaint
07/07/2023
- Complaint Type:
- Customer Service Issues
- Status:
- Unanswered
I have a regence bcbs health insurance policy. They sent me a letter saying *** is no longer in network. That appears to be incorrect, yet I can't seem to get an actual answer from them.Initial Complaint
06/21/2023
- Complaint Type:
- Order Issues
- Status:
- Unresolved
Sometime in March 23 Rotator cuff surgery pre-authorized by Regence and scheduled for 3/29/23 3/27 or 3/28/23 I paid $1,000 out of pocket for the surgery and associated costs. Around this same time, I am asked by the surgeons office who my PT will be post-surgery as I am required to have PT afterward. The doctors office then puts in the request.3/29/23 I have the rotator cuff surgery Sometime around the 8 or 9 week **** post-surgery, I get a phone call from 2 of the billing offices connected to my surgery saying that Regence is refusing to pay for the pre-authorized surgery because they have questions. Im on e-notices but havent received anything from Regence via email or via snail mail. I do eventually get a phone call from Regence.On 5/24/23, I do the questionnaire via phone indicating this is not a workers comp claim or an auto accident claim. I state that my hand got stuck behind the head rest of the back set of the car and I turned away. Several weeks later, I hold up a heavy mattress and the next day have excruciating pain. My doctors concerned I have frozen shoulder as well as a torn rotator cuff. I get an MRI in December. I pay out of pocket for PT in December and January. I see the doctor again at the beginning of February who clears me for surgery. The reference # for this is 23144016003.On 5/31/23, I get a call stating as indicated below that Regence will only pay for this if I dont have personal injury protection because they consider it a car accident.On 6/5/23 I call Regence and tell them its not and never has been a car accident but they insist they need proof that I havent used auto insurance for this. I email proof to Regence on 6/5/23.On 6/16/23, I get a call from my PT office that Regence is refusing to pay for PT.On 6/21/23, Regence still says it's not paying even with the requested auto insurance information. Reference #************.Business response
06/22/2023
Please see our attached response concerning ********************************************.Customer response
06/27/2023
Complaint: 20215906
I am rejecting this response because the response does not resolve the issue of refusal to pay for a pre-authorized surgery that was neither workers comp nor an auto accident. All this response does is require me to fill out a form with authorization to disclose protected health information.
Sincerely,
********************************************Initial Complaint
05/29/2023
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
All benefits summaries/ explanations advise that I am entitled to 25 rehabilitation (physical therapy) "visits" but I was being charged for 3-4 of my 25 visit entitlement per appointment. I could not find any info or explanation online for the discrepancy, so I called customer service and spoke with someone named ****. **** explained that Regence counts rehab services in 15 minute UNITS, regardless of how long your appointment/ VISIT lasts.The benefit info from Regence's website clearly states that I, the insured, should get 25 VISITS, but in a deliberately misleading and deceitful practice, they are reducing my benefit by 3 to 4 times what it should be, by docking me for several units each time I have a physical therapy visit. I was never told or warned of this billing practice when booking the appointment, and ultimately I think the onus is on the insurer to make sure the insured knows what benefits I actually have.Business response
06/08/2023
Please see our attached response.
Regards,
Initial Complaint
11/01/2022
- Complaint Type:
- Service or Repair Issues
- Status:
- Answered
I have been on a speciality medication (Enbrel) for almost 15 years. It has previously been either completely or partially covered by Regence bluecross blueshield. For reasons I still do not understand, in July I was unexpectedly charged $6271 out of pocket for one month of this medication. I have called the insurance company countless times. I have spoken with my physicians office. I have spoken with the pharmacy. I have spoken with my insurance representative and after hours of phone calls have gotten absolutely no answer from Regence as to why I was charged this out of pocket cost. At one point I was told it was due to a $7000 deductible but this is clearly not the issue. I say that because the month before (in June) and the month after (in august) I was charged $0. It would make no sense to be charged $0 in June and then >$6000 in July if it was a deductible issue. Also, it would make no sense to be charged $0 in August if it was a deductible issue as $6271 is less that $7000. No one will address the fact that this clearly doesn't make sense when I bring it up.Ultimately the issue is that after countless hours on the phone I have received no answers. No information as to why I was charged this amount unexpectedly. No help in resolving this issues or finding ways to avoid it in the future. I have no where else to turn for help with resolution. Clearly this is an issue from a cost standpoint but realistically it is also an issue regarding the complete worthless customer service. I am a physician and if I cannot navigate an unexpected LARGE charge for a necessary and chronic medication I cannot imagine when a less medically literate patient would do.Business response
11/14/2022
Please see our attached response concerning ************************ If you have any further questions, please let me know. -******************
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Customer Complaints Summary
18 total complaints in the last 3 years.
5 complaints closed in the last 12 months.